Minerva anestesiologica
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Minerva anestesiologica · May 2002
ReviewNew drugs, new techniques, new indications in pediatric regional anesthesia.
The use of regional anesthesia in children represents one of the most effective methods for perioperative analgesia and postoperative pain control. Things have been dramatically changed in the last two decades due to the appearance of new safer drugs and new tools; moreover new techniques were introduced showing their efficacy. In this paper we briefly describe the efficacy of new local anesthetics and adjuvants; we review the use of continuous peripheral blocks and other not very diffused techniques of regional anesthesia.
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Recovery and outcome parameters of children undergoing surgery as outpatient are reported. There are minor differences between different drugs in terms of outcome, speed of recovery and recovery adverse events. ⋯ Most complications (pain, nausea, vomiting, croup) are transient and managed before discharge. The most frequent complications at home are undertreated pain, loss of appetite, and behavioral changes.
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Minerva anestesiologica · May 2002
ReviewUse and nursing of the helmet in delivering non invasive ventilation.
Continuous positive end-expiratory pressure (CPAP) and Pressure Support Ventilation (PSV) are commonly used for the therapy of several forms of respiratory failure. CPAP and PSV can be delivered both during invasive respiratory treatment, by means of an endotracheal tube or tracheostomy, and during non invasive respiratory treatment. Non Invasive Ventilation (NIV) is commonly used for the therapy of several forms of respiratory failure (COPD, Weaning period from Invasive Mechanical Ventilation, Cardiogenic Edema,.) and the helmet could be a good new device to deliver it with a better compliance instead the common facial mask without increasing the nurses' workload.
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Minerva anestesiologica · May 2002
ReviewDevelopments in the treatment of postoperative pain in paediatrics.
Although appreciation of pain has long been ignored, and even denied, in children its prevention and treatment is now an integral part of standard patient management. The current state of strategies of pain management in infants and children are detailed in this article and we focused on new trends and future developments.
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Minerva anestesiologica · May 2002
ReviewAntithrombin III. Key factor in extracorporeal circulation.
Antithrombin III plays many different roles during cardiac operations with cardiopulmonary bypass. Basically, it acts as the natural inhibitor of thrombin, which, in presence of heparin, blocks the thrombin action and avoids gross thrombus formation inside the extracorporeal circulation circuit. ⋯ Moreover, patients pre-treated with heparin reach the operating theater with reduced levels of circulating antithrombin III; this may lead to the heparin resistance phenomenon and may further increase the risk for postoperative thrombotic complications. Finally, the anti-inflammatory properties of antithrombin III in the setting of the "whole body inflammatory reaction" induced by the cardiopulmonary bypass represents a new and unexplored field of research.